EDITORIAL BACKGROUND
INSECT STING ALLERGY
More than 2 million Americans are allergic to the venom produced by stinging insects such as bees, hornets, yellow jackets and wasps. Though anyone stung by one of these insects will experience some pain and swelling at the sting site, those who are allergic are at risk of suffering anaphylaxis, a life-threatening allergic reaction that affects many parts of the body at once. According to the American College of Allergy, Asthma and Immunology (ACAAI), insect stings send more than half a million people to hospital emergency rooms and cause at least 50 deaths each year. Experts estimate that many more deaths may occur that are never attributed to an insect sting allergy.
What is the difference between a normal insect sting reaction and an allergic reaction?
Most insect sting reactions are not allergic and often result in pain, itching, swelling and redness. The swelling may extend beyond the site of the sting but is usually treated by cleaning, disinfecting and applying ice. Antihistamines and steroids may be needed if the swelling increases and antibiotics are prescribed if the sting becomes infected.
In an allergic reaction to an insect sting, anaphylaxis can occur with symptoms such as:
• hives, itchiness, swelling in areas other than the sting site;
• tightness in the chest and difficulty breathing;
• dizziness or a sharp drop in blood pressure; and
• hoarse voice and swelling of the tongue.
In very severe reactions, a person may lose consciousness and have cardiac arrest. Severe allergic reactions usually occur immediately following a sting but may not appear until as much as 24 hours later.
How is an allergic reaction to an insect sting treated?
An insect sting allergic reaction should be treated immediately and often requires emergency care. The allergic reactions are treated with epinephrine, either self-injected or administered by a physician.
Once a person has had an allergic reaction, it's important to see an allergist. There is a 60 percent chance of that person having another similar or worse reaction if stung again. An allergist can prescribe an epinephrine kit and provide instruction on how to self-administer the injection. Parents of a child who is allergic should make sure teachers, camp counselors and other adult supervisors know, and that the child has an emergency epinephrine kit.
If injectable epinephrine is administered, immediate medical attention is still required because one dose may not be enough to reverse a reaction.
Those with insect sting allergies also may be able to prevent an allergic reaction from occurring.
How can insect sting allergic reactions be prevented?
Studies have shown that immunotherapy or allergy shots, which introduce tiny purified extracts of insect venom in gradually increasing doses, are 97 percent effective in preventing potentially life-threatening reactions to insect stings. The shots stimulate the patient’s own immune system to become resistant to a future allergic reaction. Venom allergy shots should only be administered under the care of a qualified medical specialist such as an allergist.
What are the most common stinging insects?
Stinging insects such as bees, wasps, hornets and yellow jackets are common throughout the United States. They are most plentiful and active during late summer and early autumn in most parts of the country. During those months, nest populations can exceed 60,000 insects.
Another stinging insect, the fire ant, occurs year-round and infests more than 250 million acres in the southern states.
Can insect stings be avoided?
There are ways to minimize the chances of being stung without being confined to staying indoors. Avoidance tactics are the first line of defense, and experts say the best advice is simple: don’t look, smell or act like a flower. Tips for those who are allergic to insect stings include:
• Avoid wearing bright colored clothing with flowery patterns.
• Avoid sweet-smelling perfumes, hairsprays and deodorants.
• Avoid walking barefoot in the grass, where stinging insects forage.
• Don’t drink soft drinks from cans. Stinging insects are attracted to the sweetness and may crawl inside the can.
• Keep food covered when eating outdoors.
For More Information
No matter what the cause of allergy misery, the American College of Asthma, Allergy and Immunology (ACAAI) can help consumers bring their allergies under control. For information about insect sting allergies, call the College at 1-800-842-7777 to request a free brochure Insect Stings: Advice From Your Allergist or visit its Web site at: www.acaai.org. The ACAAI is a professional medical organization comprising more than 4,950 allergists-immunologists and related health professionals dedicated to the clinical practice of allergy, asthma and immunology through education and research to promote the highest quality patient care.